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<head>
<meta charset="utf-8">
<title>无标题文档</title>
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<link rel="stylesheet" href="css/jquery.mobile-1.4.2.min.css" />
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<link rel="stylesheet" type="text/css" href="css/jkcss.css">
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<script type="text/javascript">
var storage;
var shopid;
var loginName;
window.onload = function(){
	storage = window.localStorage;
	shopid = storage.getItem("shopid");
	loginName = storage.getItem("LoginName");
}
</script>
</head>

<body>
<div data-role="page" id="page_6_3" data-theme="jk">
<div data-role="header"> <a  class="ui-btn ui-corner-all" data-rel="back" data-icon="back">返回</a>
    <h1 class="ui-corner-all">申请店铺手机端</h1>
  </div>
  <br>
<div data-role="content">
   <div class="ui-grid-a"> 
 <div class="ui-block-a">
   <input name="choose63" type="radio" class="dw-i" id="in_store" value="1">
   <label for="in_store"  style="border:none;">配货端</label>  
     </div>
<div class="ui-block-b">
  <input type="radio" name="choose63" id="out_store" value="2">
  <label for="out_store"  style="border:none">送货端</label> 
     </div>
  </div> 

    	<div class="ui-field-contain" style="margin:0 0 0 0 ;">
    	  <h4>姓名/昵称：
    	    <input type="text" name="name63" id="name63"  value=""> 
    	  </h4>
       
          <h4>新的手机号: 
            <input type="text" name="phone_number" id="phone_number"  value=""></h4>
        
          <h4>确认手机号：
            <input type="text" name="phone_number63" id="phone_number63"  value="">
          </h4>
          <h4>设置密码：
            <input type="password" name="password2" id="password2" placeholder="密码" value="">
          </h4>
         <h4>确认密码：
	   <input type="password" name="password" id="password" placeholder="密码" value=""></h4>  
 
       <h4>输入验证码：
         <input type="text" id="auth_code" placeholder="验证码" value="" style="width:150px;">
          <a style=" position: relative;top:-38px; left:170px;"> 获取短信验证码</a></h4>
             <p align="center"><a class="ui-btn ui-corner-all ui-btn-inline" onClick="" style="text-align:center; background-color:#55c3f1">设置密码</a></p>
          
    </div>      

</div>
</body>
</html>
